Single–suture line placement of a pericardial stentless valve

Abstract

Objective: Implantation of bioprostheses in the supra-annular position with the single suture line was first applied by O'Brien to porcine stentless valves. The aim of this study was to evaluate the clinical performance of the Pericarbon Freedom stentless bioprosthesis (Sorin Biomedica Cardio, Saluggia, Italy) implanted in supra-annular position with the single-suture line technique. The single-suture approach for the Pericarbon Freedom stentless bioprosthesis is obtained by trimming away all the extra tissue of the valve inflow side and scalloping the outflow side.Methods: Between February 2002 and August 2004, a total of 65 consecutive patients at our institution (48% male, mean age 69 Ϯ 12 years) underwent aortic valve replacement with Pericarbon Freedom stentless bioprostheses implanted with a single suture line. Most recurrent etiology was senile degeneration (80%). Pericarbon Freedom 25-mm and 27-mm valves were the most frequently implanted. Thirty patients had concomitant procedures (mainly coronary artery bypass grafting, 16 patients). Overall crossclamp time was 76 Ϯ 21 minutes.Results: All patients survived intervention. One patient died early of multiorgan failure (postoperative day 16). There were 4 early non-valve-related complications and no late complications at a mean follow-up of 491 Ϯ 270 days. Four patients showed trivial central prosthetic regurgitation at intraoperative transesophageal echocardiography; among these cases, only 1 was confirmed at 6-month transthoracic echocardiography. At postoperative echocardiographic assessment, mean pressure gradient for the 25-through 29-mm size group was 10.2 Ϯ 7.1 mm Hg, and peak pressure gradient was 18.1 Ϯ 12.3 mm Hg.

Early postoperative hemodynamics and clinical outcomes of patients receiving freedom solo aortic calve replacement; the Asian Experience

“…Current result for LVEF was contradicted by some other researches. Their researches showed the improvement in LVEF after FS valve replacement (21,20). Although our study demonstrated reduction in LVEF, the mean LVEF was still in normal range.…”

“…The AVA was improved from 0.78 ± 0.35 cm2 preoperatively to 1.90 ± 0.56 cm2 at 1 month and 1.89 ± 0.56 cm2 at 12 months. (21) Based on current observation, the result of LVEF demonstrated a reduction from 65.75 ± 6.30 % to 61.25 ± 11.84 % within 5 months postoperatively. Current result for LVEF was contradicted by some other researches.…”

The Freedom SOLO bovine pericardial stentless valve

“…The design modification that resulted in the FS was aimed at allowing subcoronary, supra-annular implantation with only one suture line, achieved through the trimming of all extra tissue from the PF valve inflow side, and the scalloping of the outflow side to preserve the valve assembly suture. 20 As such, the FS combines the latest-generation bovine pericardial tissue and novel anticalcification treatment, with the singlesuture, subcoronary implantation technique first applied by O'Brien to porcine stentless valves. 21 This design allows imitation of the native healthy valve through unrestricted adaption to each individual patient's anatomy.…”

“…Care must be taken to avoid any laceration of the valve leaflets with a needle tip and also to prevent any damage of the assembly suture of the valve. Some surgeons have suggested to start suturing at the right coronary sinus, followed by the left coronary sinus, and finally the NC sinus, 20 but in fact, any order can be followed 25 ( Figure 2F). There is large individual variability in root anatomy, and the NC sinus often presents wider and deeper than the symmetric prosthesis.…”

Quality of life after aortic valve replacement with biological prostheses in elderly patients

“…К альтернативным методам лечения относятся протезирование аорталь-ного клапана биологическими протезами бескаркасной конструкции. Более требовательная к хирургической технике имплантация с одной стороны и приводящая в результате к лучшим гемодинамическим характеристи-кам с другой стороны, операция с применением бескар-касных биологических протезов становится вариантом выбора при хирургическом лечении сенильных аорталь-ных пороков сердца [10][11][12][13].…”